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World Changers (3.14.2025)
Dr Jack Cush and his podcast friends are out to change the world. Here is his weekly review of the news and journal reports from the past week on RheumNow.
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Intraarticular Steroids in OA Lowers Need for Pain Meds
MedPage Today
Is it possible that intra-articular corticosteroid injections for osteoarthritis might affect the use of opioids?
Opioid Deaths are Down (2.28.2025)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Opioid deaths are down, IL-33 levels are up and Weight loss is in the news again this week!
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Loss of Good Sleep Linked to All-Cause Mortality
A US study shows that nearly two-thirds of the population had suboptimal 5-year sleep duration trajectories with a resultant 29% increase in risk of all-cause mortality.
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Can you distinguish which PsA? Persistent inflammatory (PIPsA) vs non-inflammatory PsA (NIPsA)? NIPsA has normal ESR/CRP, w/ obesity, biomechanical pain, OA, fibromyalgia, secondary post-inflam damage or central pain mechanisms. https://t.co/9SRmpNfXCF https://t.co/wsH6poUO1m
Dr. John Cush RheumNow ( View Tweet)
Metanalysis of 376 studies, 347 468 pts w/ chronic pain (mean 51yrs; 70%F) finds ~40% had clinically significant depression and anxiety (more common in Women, younger people, pts w nociplastic pain). Depression common in FM (54%) & OA/RA (~28%). https://t.co/s1tcgC3y7k https://t.co/NCxkOA82jD
Dr. John Cush RheumNow ( View Tweet)
Intraarticular Steroids in OA Lowers Need for Pain Meds
Is it possible that intra-articular corticosteroid injections for osteoarthritis might affect the use of opioids?
https://t.co/qkTN7CpuMZ https://t.co/npuT88Sj2m
Dr. John Cush RheumNow ( View Tweet)
CDC: More women (25.4%) than men (23.2%) had chronic pain in last 3 mos, Esp in large central metropolitan areas(22% vs 19%, F>M). For both recent chronic pain increased with decreasing urbanicity. https://t.co/rDsCQWvAae https://t.co/mhczpWFsdw
Dr. John Cush RheumNow ( View Tweet)
Intraarticular Steroids in OA Lowers Need for Pain Meds
Is it possible that intra-articular corticosteroid injections for osteoarthritis might affect the use of opioids?
https://t.co/pw6vWbFRQx https://t.co/5KrB9uJv7M
Dr. John Cush RheumNow ( View Tweet)
Sleep disturbance increases disability progression - Prospective cohort data from from 70K Nurses’ Health Study w/ 392 having MS, 7,302 DM, & 25K OA. Having Sleep apnea or disturbances signif incr disability in OA & DM (OR~1.4) as was excessive daytime sleepiness… https://t.co/5PP18gqDqi https://t.co/u1HFOstv8W
Dr. John Cush RheumNow ( View Tweet)
I ALWAYS recommend paraffin wax baths for stiffness, RA, OA, PSS, etc.
Here are some instructions for home use https://t.co/CTI4K2kHf9 https://t.co/i0kO99vdYc
Dr. John Cush RheumNow ( View Tweet)
RNA-seq analysis of human chondrocytes (HTC) shows Osteoarthritis has more HTC-1 (w/ more cell apoptosis & PD-1 genes) & proliferate fibrochondrocytes (ProFC2) w/ heightened inflammatory response, & increased cytokine signalling https://t.co/FZ72CnWk20 https://t.co/sx4NB2C8h3
Dr. John Cush RheumNow ( View Tweet)
Eric Dein @ericdeinmd
Active Morphea: - MTX +/- steroids. If not effective, MMF/RTX/ABA - Topicals for circumscribed - Phototherapy Most pts achieve remission in active in 1 year Inactive morphea - Can address with PT, pain rx, psychological support, plastic surgery fat… https://t.co/wEnlo6vtAB https://t.co/4uJYC9HaS1
Dr. John Cush RheumNow ( View Tweet)
Eric Dein @ericdeinmd
Active Morphea: - MTX +/- steroids. If not effective, MMF/RTX/ABA - Topicals for circumscribed - Phototherapy Most pts achieve remission in active in 1 year Inactive morphea - Can address with PT, pain rx, psychological support, plastic surgery fat… https://t.co/OMGt8feO0z https://t.co/yWAgY2Z4Ng
Dr. John Cush RheumNow ( View Tweet)
Janet Pope @Janetbirdope
#ClinicalPearl Insights into #fibrosing #skin conditions Inflammatory Fibrotic Atrophy We treat the #inflammation but need to determine if lesions are active or not Bx May not discern #dx Heidi Jacobe #RNL2025 https://t.co/dG1k4fm4aO https://t.co/5TowCCDiTt
Links:
Dr. John Cush RheumNow ( View Tweet)
Cannabis Hospitalizations and Mortality Risk
A Canadian population, retrospective cohort study shows individuals needing hospital-based (emergency department or hospitalization) care for a cannabis use disorder (CUD) were at increased risk of death.
https://t.co/MQtR3etpEH https://t.co/ZB4byi81on
Dr. John Cush RheumNow ( View Tweet)
The ‘dark’ side of
#Hidradenitis #suppurativa
👇
Smell of leaking lesions #HS
⬆️skin folds, buttock, axilla, also thighs, neck
⬆️depression
@RheumNow #RNL2025
‘ If pt doesn’t get in gown then not ready for systemic #Rx!’
Jennifer Clay
#ClinicalPearl https://t.co/tZzz5tielt
Links:
Janet Pope Janetbirdope ( View Tweet)
Full read review and overview of Fibromyalgia - manifestations, pathophysiology, treatments and guidelines. Multidisciplinary, patient-centered treatment should includes a combination of pharmacological and nonpharmacological options. https://t.co/x4OVeQ5RJz https://t.co/i1fD6XQbnx
Dr. John Cush RheumNow ( View Tweet)
FDA has approved Journavx (suzetrigine) 50 mg tablets, 1st in-class non-opioid analgesic, to treat moderate to severe acute pain in adults. Journavx reduces pain by targeting a pain-signaling pathway involving sodium channels in the peripheral nervous system, before pain signals… https://t.co/qjtr4yz8Ot https://t.co/RUZmLgsmTv
Dr. John Cush RheumNow ( View Tweet)
OK this is ‘HOT’
App on phone for a
👇
#thermal #camera
Of hands 🙌
If #hot➡️ flare of #inflammatory #arthritis
And call for a #follow up apt
If not — then not a flare
#AI #artificial #intelligence
#rheumatoid #arthritis
@RheumNow #RNL25
Jeff Curtis AI in #rheum
Janet Pope Janetbirdope ( View Tweet)
